New Richmond Youth Hockey Association

Name (First and Last)*

Email*

Phone Number*

What age group(s) are you interested in coaching? (List all)*

What is your role preference? (Head, Assistant, Mites)*

Desired Level (Select all that apply)*

A Level

B Level

C Level

Unknown - want to coach child

Open to all

If you do not get selected for the desired level, would you be willing to help coach another team?*

Yes

No

Maybe

List Day/Time Schedule Limitations*

Describe your hockey coaching experience (optional)

Have you coached for NRYHA in the last 5 years? (If yes, you can submit application now)*

Yes

No

If you have not coached in NRYHA, please provide a list of references.

Please List Association(s), Teams, Years, Position or enter None if no prior experience. Please state if you were a head coach or an assistant coach

Are you USA Hockey Certified (CEP)?

Yes

No

Not Current

Hockey Background Years played, highest level competed at, teams, etc.

Coaching Application